Labiaplasty: What's really going on down there?

By Dr. Robert Schwartz | 10/17/2018

The Labiaplasty Boom

Historically and mostly in cases of congenital abnormalities, labiaplasty was a rarely performed procedure. Effective, but rarely performed. But in the last ten years, it has become in my practice, and I assume most others, a very popular surgery. So why the sudden popularity?

The Internet

There is a lot of nudity on the internet. Or so I’m told. Historically, most women did not know what other women’s vaginas looked like in any particular detail. Now that knowledge is three seconds away (two with a fiber internet connection). Add to that, the existence of photoshop and keeping the visual appearance of labia in perfect presentation at all times. Seeing inevitably leads to comparison. Questions I have actually had in my office range from, ’“Does my vagina look normal?” and, “Is it pretty?” I can only conclude that if patients are asking for my professional opinion, they are probably asking their partners, their best friends and probably their mothers and sisters too...Now that the questions are being asked, the answers sometimes lead to insecurities. This is the primary driver of labiaplasty today. We now have, thanks to the internet, a somewhat defined set of goals for what a normal and pretty vagina looks like. And women want to be normal-looking and pretty. Everywhere.

Pubic Hair. Or Actually, Lack Thereof.

Apparently, sometime in the late 80’s women received a memo telling them to groom their pubic hair. In the 90’s the memo was updated - “Stop grooming. Start shaving.” This cultural shift in personal grooming, along with famous celebrities have all have helped transition the female culture to desiring complete and total hair removal as a means for a cleaner, low maintenance lifestyle south-of-the-border. Whether it be shaving, waxing or laser, women just want it gone, and now the what’s left has become the focus.

Fashion

With the ever-changing tide of fashion, tight yoga pants and crotch-contouring leggings, skimpy bikinis and thongs have all aimed flashing lights at the appearance of the labia through clothing. For some women with more pronounced labia, these snug clothes can actually be painful to wear. A labiaplasty solves both these problems.

Spinning Into Surgery

Ok, this may be a minor factor but I’ve seen more than a few women who first discovered they had a problem in a spin class. I’m told forty-five minutes on a bicycle seat feels like an eternity when you’re in pain down there.

OK, That Sounds Like Me But What Do I Do About It?

Labiaplasty can be as simple as numbing the inner labia with local anesthetic and trimming the excess tissue. There are several different ways to remove the extra tissue so the technique can be customized to your anatomy and desires. Most procedures can easily be done in the office. They take 30-60 minutes and downtime is virtually nil. Some women prefer IV sedation or general anesthesia and we can do the procedure this way as well. The outer labia can also be rejuvenated at the same time usually by injecting fat. This restores fullness that is often lost with aging or childbirth. In well-documented studies, 89.7% of labiaplasty patients felt better about the appearance of their vaginas after the procedure. Of those who had pain or other functional problems, 92.3% were cured. And 91.6% women experienced improved sexual functioning after labiaplasty.